Burke County Fuel Ticket
* Please note changes to date, agency and vehicle fields *
*
Date Fuel Pumped:
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Division or Agency?
EMS
Fire Marshal
Emergency Management
Sheriffs Office
Public Works
Narcotics Task Force
Med Center Air
Parks & Recreation
Other:
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Type of Fuel?
Diesel
Gasoline
*
Gallons?
*
County Vehicle #:
319
320
321
322
323
324
325
326
327
328
329
330
331
332
335
334
335
336
337
338
339
MCA 215
MCA 218
MCA Other
NCTF Other
Mower (Rick Clark)
Vehicle (Rick Clark)
Recreation # 811
Other
*
Mileage
*
Location Fuel Pumped From?
EMS Station 1
EMS Station 2
EMS Station 3
*
Employee Pumping Fuel?
*
Indicates Response Required